Edwin Lemuel Anderson, M.D.

Primary specialty

Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X

License

R5J69 Issued in MO

Practice address

1100 S Grand Blvd FL 1
Saint Louis, MO 63104-1015

Phone

(314) 977-7534

NPI assigned

Jan 11, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1295885580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S GRAND BLVD FL 1",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041015",
            "telephone_number": "314-977-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S GRAND BLVD FL 1",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041015",
            "telephone_number": "314-977-7534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "EDWIN",
        "middle_name": "LEMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "NC",
            "license": "19571",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "MO",
            "license": "R5J69",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Anderson
• David Henry Anderson
• David James Anderson, MD
• Derek Anderson
• Dolores Jeannine Anderson, LPN
• Emily D Anderson, LCSW
• George C Anderson, MD
• Haley Anderson, PHARMD
• Holly Etta Anderson, P.T.
• Jasmine Anderson

• All providers in Saint Louis, MO
• Pediatric Infectious Diseases Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.